Urology in Japan

Urology is a branch of medicine that deals with the diseases of the female and male urinary tract (kidneys, ureters, bladder, and urethra). This branch of medicine also deals with male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate, and penis).

Urology has a number of sub-disciplines, including:

• Endourology – this sub-discipline of urology deals with the closed manipulation of the urinary tract. It includes all minimally invasive urologic surgical procedures, such as prostate surgery and stone removal surgery.
• Urologic oncology – this focuses on the treatment of malignant genitourinary diseases, such as cancer of the bladder, prostate, kidney, ureters, adrenal glands, testicles, or penis.
• Neurourology – this deals with the treatment of conditions involving the nervous control of the genitourinary system or abnormal urination.
• Pediatric urology – this focuses on urologic disorders in children, such as congenital abnormalities of the genitourinary tract, cryptorchidism (undescended testes), underdeveloped genitalia, enuresis, and vesicoureteral reflux.
• Andrology – this deals with disorders of the male reproductive system, such as ejaculatory disorders, erectile dysfunction, vasectomy reversal, and infertility.
• Reconstructive urology – this is a highly specialized field of male urology that deals with the reconstruction of both the structure and function of the genitourinary tract.
• Female urology – this deals with conditions of a woman’s reproductive and urinary tract, such as pelvic organ prolapse, overactive bladder, and urinary incontinence.

Medical professionals specializing in the field of urology are called urologists. Urologists can diagnose and treat diseases of the urinary tract in both women and men, as well as diagnosing and treating any problems in men’s reproductive tract. In some cases, urologists may also perform surgery. In the case of certain conditions, urologists may need to work in conjunction with medical professionals who specializes in other fields, such as oncologist, radiotherapists, nephrologist, and gynecologist.

Urologists can treat the following conditions:

In men:

• Prostate gland enlargement
• Cancers of the penis, bladder, testicles, kidneys, and adrenal and prostate glands
• Erectile dysfunction
• Infertility
• Kidney diseases
• Kidney stones
• Interstitial cystitis, also known as painful bladder syndrome
• Prostatitis
• Varicoceles, or enlarged veins in the scrotum
• Urinary tract infections (UTIs)

In women:

• Cancer of the kidneys, bladder, and adrenal glands
• Bladder prolapse, or a condition in which the bladder drops into the vagina
• Kidney stones
• Interstitial cystitis
• Overactive bladder
• Urinary incontinence
• UTIs

In children:

• Blockages and other problems with the urinary tract structure
• Bed-wetting
• Undescended testicles

What does Urology Involve?

During your first appointment, your urologist may ask you questions about your health history, any medicines you take, and your current symptoms. Your urologist may do a physical exam that includes a rectal and genital exam. They may also do some tests, such as:

• Imaging tests, such as MRI scans, CT scans, or ultrasound to help them locate the problem.
• A urine test to check for bacteria or other signs of disease.
• A cystoscope (a long, thin tube with a camera on its end) to see inside the urinary tract and take a sample of tissue for testing.
• A biopsy to check for cancer and other disorders.
• Urodynamic testing to check how fast the urine leaves your body, how much pressure there is in your bladder, and how much urine remains in your bladder after urinating.

After your urologist makes a diagnosis, the treatment will depend on your specific condition. It may include the use of medications and surgery.

Types of medication include:

• Hormone treatment for prostate cancer
• Antibiotics for infections
• Phosphodiesterase 5 (PDE5) inhibitors for erectile dysfunction
• Chemotherapy drugs for cancer
• Drugs that act on the smooth muscle of the bladder to help reduce urinary incontinence.

Some of the most common types of surgery include:

• A cystectomy, which is a procedure to remove the bladder. This procedure is used to treat cancer.
• A kidney transplant, which involves replacing a damaged or diseased kidney with a healthy one.
• Extracorporeal shock-wave lithotripsy, which is used to break up kidney stones so they can be removed more easily.
• A repair of damage to the urinary tract due to injury.
• A procedure to open a blockage.
• A repair of urinary organs that are not well-formed.
• A prostatectomy, which is used to remove all or part of the prostate gland. This procedure is performed to treat prostate cancer.
• Transurethral needle ablation of the prostate, which removes excess tissue from an enlarged prostate.
• Transurethral resection of the prostate, which involves the removal of excess tissue from an enlarged prostate.
• A sling procedure, which uses strips of mesh in order to support the urethra and keep it closed. This procedure can treat urinary incontinence.
• A ureteroscopy, which involves the removal of stones in the kidneys and ureter using a scope.
• A vasectomy, which is a procedure to cut and tie the vas deferens, or the tubes that carry sperm. This is done to prevent pregnancy.
• A nephrectomy, which involves removing a kidney to treat cancer.

The surgery can be performed in one of two ways: open through a large incision, laparoscopically through several tiny incisions. Both methods are usually performed under general anesthesia. In some cases, local anesthetic may be used instead.

How Long Should I Stay in Japan?

Depending on the procedure you will have, you may be able to leave the hospital on the same day or you will have to stay for up to 5 days. In general, it is highly advisable that you stay in Japan for several days following your procedure for initial recovery and to attend scheduled follow-up checkups. For surgical procedures, you may need to stay in the country for at least 10 to 14 days.

What's the Recovery Time?

The recovery time varies, depending on the procedure you have, the reason why you need the procedure, and your overall health. For surgical procedures, it may take about one to six weeks until you can go back to your full activity. For non-surgical procedures, you may be allowed to go back to your normal routine within several days. Your urologist will give you a detailed recovery timeline, which includes the time you can go back to work, normal activity, and strenuous activities, such as exercise and heavy lifting.

What About Aftercare?

Your urologist will give you a set of instructions for your aftercare. The instruction may include a diet plan, exercise, restrictions, and medication to take, and wound care. It is important that you follow every instruction closely. After surgery, you will be encouraged to do some light exercise, such as walking, to help your healing process. You may also need to eat easily digestible food until you are recovered.

Depending on your specific condition, you may need to attend regular checkups following your treatment. For instance, if you had cancer treatment, your doctor will suggest you attend a checkup once or twice a year to ensure that cancer has not come back.

What's the Success Rate?

The field of urology is at the forefront of research and innovation. Due to its constant advancement, the procedures are becoming more effective and safer. Each urological treatment is also known to offer high success rates. However, any procedure comes with risks, such as infection, bleeding, and damage to nearby organs. Therefore, it is important that you choose a skilled and experienced urologist.

Are there Alternatives to Urology?

If you have any injury or disease in your urinary tract and/or reproductive organ (for men), there is no other alternative besides visiting a urology department. However, if your disease is found to be caused by other problems, the doctor will refer you to a relevant doctor.

Urology in and around Japan

About Japan

Japan is special in its own way; the culture, food, people, as well as technology are envied by the world over. With old Japan, comes the ancient tradition in the form of a geisha performance, onsen (hot spring) visit in the mountains, tea ceremony, or shrine visit. In contrast, there is modern Japan, full of smart systems and electronics, colorful advertisements and displays, and ultra-modern architecture. In recent years, Japan has become one of the top destinations in the world for oncology treatments and sees many tens of thousands of medical tourists each year. Many of these travel from within the region, including China and Korea, but they are unable to compete with the SE Asian nations with prices. Private hospitals are located across the country, with a particular focus in major cities like Tokyo, Kyoto, and Osaka. 25 of these facilities are JCI-accredited, with many offering Urology procedures.

Popular Parts of Japan

Located in the Pacific Ocean, Japan is a stratovolcano archipelago. The four largest islands are Honshu, Hokkaido, Kyushu, and Shikoku. With a population of 127 million, 98% are ethnic Japanese. The country perfectly balances traditional with modern technology. Tourists will first see its exceptionally modern face, but after traveling around, they will find many opportunities to connect with the beautiful traditional culture.

• Tokyo is Japan’s capital, one of the 47 prefectures of Japan. It’s a huge metropolis that offers traditional arts and culture, futuristic infrastructures, and good restaurants. The cherry blossoms that bloom in Spring is one of the most popular sights. The soft pink petals are an icon of the country. There is an unlimited choice of shopping, many museums that cover every era of Japanese art history, and even a robot restaurant.
• Kyoto is made of religious architecture, with around 2000 temples and shrines. It moves at a slower pace than any other city in Japan. Filled with samurais, geishas, Zen gardens, and the torii gate, Kyoto is the spiritual center of Japan. The city is also known for its food, head to the Nishiki Market, a four-hundred-year-old local food market that offers a range of national cuisine to modern food from all over the world.
• Osaka, the second largest metropolitan area after Tokyo is known to be the most delicious city. The city is nicknamed “the nation’s kitchen.” Visit Dotonburi to experience the food culture of Osaka. Besides the food, there are numerous attractions that tourists should visit such as Universal Studios Japan, Cup Noodles Museum, Aquarium Kaiyukan, Osaka Castle, and Umeda Sky Building.
• Fukuoka has a welcoming feel with sunny weather and so much to do. It’s made up of two towns, the port city of Hakata and the former castle town of Fukuoka. Visit the impressive Fukuoka Castle, explore the Sumiyoshi-Jinja Shrine, learn history in Kyūshū National Museum, experience the ancient art of calligraphy and origami in Hakata Machiya Folk Museum, and enjoy a calming bath in one of the Onsen hot springs.
• Nagoya is the industrial center of Japan. It’s the birthplace of Toyota and a popular pinball-style game Pachinko. Although many of the historic buildings were destroyed in the air raids of 1945, tourists can still indulge in its culture and tradition. Visit the Nagoya Castle that was reconstructed in 1959, walk around the Atsuta Shrine, or see the history of the automobile in the Toyota Automobile Museum.

Weather and Climate in Japan

Japan has four distinct seasons.

1. Summer starts in June and lasts until August. The temperature can get very hot, up to 40 °C in some places, with high humidity. June is the rainy season where the farmers plant their rice. The rainy season is over in August but the typhoon season starts to peak.
2. Autumn starts in September and ends in November. September has the greatest risk of typhoons. The weather is generally mild. October is pleasantly warm with less humidity than in summer, making it a food time for traveling the country.
3. The temperature will drop in Winter. It lasts from December to February and is usually dry, pleasant, and sunny. The average temperature is around 2°C to 12°C, it rarely drops below 0°C. The northern island of Hokkaido, the Japan Alps, and the Japan Sea coast get a lot of snow while Tokyo gets very little snow.
4. Spring is said to be the best time to visit Japan because of its mild weather and cherry blossoms. The season starts in March and ends in May. The temperature will gradually increase during spring with little rainfall and clear sky.

Getting Around in Japan

The main airport for international tourists is the Narita International Airport. It is located around 60km east of central Tokyo. It serves both domestic and international flights to almost every major city around the globe. There are several budget airlines that operate flights from this airport, namely Jetstar Japan, Eastar Jet, and Peach. There are other international airports such as Kansai International Airport, New Chitose International Airport, and Kyushu Saga International Airport.

To get to Tokyo from Narita Airport, tourists can use the rail, bus, taxi, or car rental. The most affordable train line is the Keisei Line that connects with the Toei Asakusa Subway Line and the Yamanote Line, it costs around ¥1,190 to ¥1,230 ($10 to $11.3). There’s also the Sky Access Express train that offers better access to Tokyo, a trip to Asakusa will cost around ¥1,290 ($11.9) and take about 58 minutes. The quickest way to get to Tokyo will be by the Skyliner train, it takes just 36 minutes to Nippori and will cost around ¥2,470 ($22.7). The airport introduced N’EX Tokyo Round-Trip ticket for foreign passport holders that provides round-trip travel from Narita to Tokyo and back for ¥4,000 ($37) for adults and ¥2,000 ($18.4) for children.

A regular taxi from Narita to Tokyo is very expensive, usually over ¥20,000 ($184). The best option is the shared minibus that starts with ¥6,180 ($57) per person. Buses are usually more affordable, the Limousine Bus costs ¥2,880 ($26.5) and the Tokyo Shuttle costs around ¥900 ($8) to ¥1,000 ($9).

Getting around Japan is fairly easy because the country has excellent public transportation. It is recommended to get a Japan Rail Pass. Japan’s bullet train is fast but expensive. There are cheaper train options. Buses are less expensive but will take more time than trains.

Tourist Visas in Japan

Citizens of 68 countries and territories can enter and stay in Japan for up to 90 days without a visa. Citizens of Indonesia, Brunei, and Thailand are granted a 15-day visa-free trip to Japan. Citizens of the United Arab Emirates are allowed to stay for 30 days without a visa. It is advisable to contact the nearest Consular Section of the Embassy or Consulate General of Japan for more information.

Additional Information

1. Local Currency: Yen (¥) is the local currency. $1 will get you ¥11 ¥1,000 is worth approximately $9.
2. Money & Payments: ATMs are usually located in post offices and convenient stores. There are only a few branches of major Japanese banks that accept foreign-issued cards. Credit cards are accepted in major cities, but the rural area doesn’t. It’s best to always bring cash and bring a coin purse because everything below ¥500 is coins. Tipping is not mandatory, high-end hotels and restaurants usually add a 10% service fee to the bill.
3. Local Language: The official language is Japanese. English is common in major cities with many tourists such as Tokyo, Osaka, and Tokyo. Some restaurants write their menu in English and Japanese.
4. Local Culture and Religion: The dominant religion in Japan is Shinto and Buddhism. There’s a small group of Christians as well.
5. Public Holidays: Japan has sixteen national holidays each year, including Children’s Day, Constitution Memorial Day, and Marine Day. The country hosts numerous annual festivals such as Gion Matsuri in Kyoto, Awa Odori in Tokushima, and Yuki Matsuri Snow Festival in Sapporo.